Substance Abuse Therapy : Ambulatory Care Settings

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Substance Abuse Treatments in Ambulatory Care Settings Kristine Pardilla Samuel Merritt University July 22, 2015 There are various care settings wherein substance abuse therapy services are provided. This include primary care clinics, urgent care center or the hospital’s emergency department, freestanding substance abuse treatment or mental health facility, intensive outpatient and partial hospitalization programs and acute care inpatient settings. The American Society of Addiction Medicine (ASAM) developed a clinical tool called Placement Criteria, Second edition, revised (PPC-2R), to match patients’ care needs for substance abuse detoxification and the suitable care environment. Placement determination is evaluated according to…show more content…
Commonly abused substances include alcohol, tobacco, stimulant, cannabis and opioids. There are different pharmacotherapies for various types of abused substances. Multiple substance abuses require therapy for each of the drug that is being exploited. For tobacco addiction, over-the-counter nicotine replacement therapies in the form of patch, lozenge, spray or gum are available. In addition, prescription medications like bupropion and veranicline, which prevent relapse, are used. Alcohol dependence treatments include naltrexone, acamrosate and disulfiram. Naltrexone inhibits opioid receptors that play a role in the pleasure effect of drinking and craving for alcohol. Acamprosate is believed to have effects on reducing withdrawal symptoms like insomnia, anxiety, restlessness and depression. This may be appropriate for patients who are severely alcohol dependent. Disulfiram impedes the breakdown of alcohol which results in vexing symptoms like nausea, flushing, and palpitations if the patient consumes alcohol (National Institute on Drug Abuse, 2009) Methadone, buprenorphine and naltrexone are potent in managing opioid use disorder (OUD). Diagnostic criteria for OUD according to Diagnostics and Statistics Manual 5 (DSM-5) is having two or more of the following within a 12-month period: (1) persistent eagerness or failed attempts to decrease or control use of opioid, (2) A great deal of time is spent in activities necessary to
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